Gulf boom takes its toll on the mental health of people in Kerala

The Gulf boom, which has given 2.07 lakh workers jobs and transformed villages into "mini-Dubais", has taken its toll of the mental health of the people. Nervous disorders are common, marriages break-up frequently - even children have not been spared.

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. Raj Chengappa

August 27, 2013

ISSUE DATE: September 15, 1982

UPDATED: August 27, 2014 18:10 IST

A woman receiving psychiatric help: The worst hit

The markhana family in Kerala has at last discovered the good life. With two sons working in the Gulf as mechanics and earning over Rs 8,000 between them, the family back home in Edapul taluk in Mallapuram district has pulled itself out of grinding poverty.

After the brothers got their jobs two girls have been married off, a terraced house stands in the place of the old thatched hut and three acres of land have been bought. The family, however, has not been able to enjoy this new-found prosperity.

For the last year, the youngest son, Kumar, a 27-year-old taxi-driver has been suffering from attacks of breathlessness followed by severe anxiety and depression and has been put on sedatives by psychiatrists.

Kumar's neurosis started soon after his brothers left for the Gulf. Psychiatrists feel that the disparity in his income, Rs 150 a month, and that of his brothers' has brought on these attacks. He is not the only one in the family to suffer. Nalini, the wife of the eldest son, Unnikrishnan, has also had spells of neurosis. Married for three years, she sees her husband for a month every year when he comes home on leave. The psychiatrist treating her says that the prolonged separation from her husband has played havoc with her nerves.

Common Complaints: The plight of the Markhanas is not isolated. The Gulf boom, which has given 2.07 lakh workers jobs and transformed villages into "mini-Dubais", has taken its toll of the mental health of the people. Nervous disorders are common, marriages break-up frequently - even children have not been spared.

The very fabric of domestic life in the state is being lorn apart. Leading psychiatrists report an unprecedented spurt in the number of persons falling ill in the state with at least half of them belonging to the so-called "Gulfite" families.

According to the Director General of Health Services. Kerala last year had the highest number of mental disorders in the country with 8,970 patients being admitted to its three mental hospitals in Trivandrum, Trichur and Calicut. This was 1,201 more than Bihar which followed with 7,769 cases. With three out of every 10,000 persons suffering from mental illness, Kerala also has the dubious distinction of having the highest frequency of mental disorders apart from topping the list for bed-occupancy rates with seven patients for a bed a year.

The problem of mental illness has been found to be especially acute in the 'Gulf pockets' of the state. Of the 2.07 lakh people who emigrated from Kerala, the four districts of Trichur, Mallapuram, Cannanore and Trivandrum accounted for 63.4 per cent of them. In Trichur district, which has the highest number of emigrants in the state, Dr TV. Francis, medical superintendent.

Government Mental Hospital, estimates that "almost every second family which has a relative in the Gulf has a history of mental illness." A majority of these cases are handled by the 70 psychiatrists practising privately in the state and do not find their way into government statistics.

Domestic Discord: In Calicut, the seniormost psychiatrist in the state, the dapper 52-year-old Dr S. Santhakumar, describes the spate of Gulf victims as a "serious psychological problem." Santhakumar, who is also the advisor for mental health to the state Government, gloomily observed: "The entire family situation seems to be heading for a total breakdown in the Gulf belts of the state."

The number of patients admitted to the Mental Hospital in Calicut had gone up from 2,975 in 1977 to 3,517 last year and Santhakumar said that a majority of them belong to Gulf families. "It's a problem that cannot be dismissed or ignored," warns Dr M.V. Geevarghese, a leading private psychiatrist in Trichur.

Geevarghese said that in the past five years the number of his patients had almost doubled as "not one of these families seem to be living in peace." This seems to be a boom time for psychiatrists'in the state, with the number of practitioners increasing from a dozen before the Gulf exodus to its present strength of 70.

Four months after he opened his clinic in Chavakkad taluk in Trichur district, 29-year-old Dr R.M. Syed Mohammed said that he is attending to a 1,000 patients, at least 600 of whom belong to Gulf families. Chavakkad taluk has sent 17,160 people to the Gulf which is nearly 43 per cent of the total of 40,224 that have emigrated from Trichur district.

Incompatibility: Tragically most of the mental instability has occurred amongst women aged between 15 and 25 years. Most of them have husbands working in one of the West Asian countries, "it's their incompatibility with their in-laws which lead to most women cracking up," says Francis.

Most of the women are from Muslim families, as at least 60 per cent of the emigrant population in the Gulf is Muslim. The problem is aggravated because of the low literacy rates with more than 65 per cent of them not having passed secondary school.

Workers in the Gulf normally marry when they come on leave and after a quick honeymoon they go, leaving their wives, usually pregnant, with their parents. With two lakh emigrants sending Rs 500 crore every year to their families, trouble begins as the money is shared.

The cash is normally sent to the emigrants' parents and often the wife gets very little. This leads to quarrels and in many cases the wives have fallen mentally ill when they are unable to cope with in-law problems.

Mohammed reports a case in which an 18-year-old housewife in Chavakkad married to a Gulfite tried to drown herself twice after her mother-in-law ill-treated her. Another woman from a nearby village called Elalluly, who is married to a driver working in Dubai, had a nervous breakdown after her in-laws abused her and refused to part with any money that her husband had sent.

The turning point proved to be when a letter she wrote to her husband asking for money was intercepted by her mother-in-law. She has now returned to her hometown but is still mentally ill. Her condition deteriorated further when she delivered a baby and none of her husband's relatives visited her; nor was he present on the occasion.

Frustration: Psychiatrists like Santhakumar believe that prolonged post-marital separation leads to deviant sexual behaviour by both partners, ending in guilt and tension. With sexual frustration building up, many wives have entered into extra-marital relationships. In Nilambur, a 25-year-old woman married to a construction worker in Abu Dhabi seduced her 21-year-old brother-in-law. The result is that the boy has become psychotic because of his guilt feelings. To overcome their frustration many of the emigrants to the Gulf have become homosexual or have started going to prostitutes.

In a recent case in Dubai, an emigrant took his brother-in-law over by promising employment but kept him as his lover. The prolonged separation has also led to sexual impotency and premature ejaculation in men, leading to more mental tension.

An old thatched hut next to

The problem has become acute with most of the Gulf countries passing strict rules restricting emigrants from bringing their families with them. These separations have also fuelled suspicion with each partner suspecting the other's fidelity and many marriages have not withstood the pressure.

In Mallapuram, one migrant felt that his wife had delivered too early and had the baby's blood tested to see if it matched his. Because of the easy divorce laws for Muslims, "postal divorces" have become common with many Muslims breaking matrimonial bonds with a letter after they suspected their wives' fidelity.

Six months ago, V.M. Sethu, 48, of Chemanoor, who has spent the last five years in the Gulf, divorced his wife of 22 years by post as he suspected her. After that he suffered a breakdown and had to be treated for psychosis in India. Sethu went back to his wife when he realised that she was innocent and it was only their months of separation that had put doubts in his mind. But not many have happy endings like Sethu's. K. Beeru Sahib, 58, chairman of the Chavakkad Municipal Council said: "Divorces are becoming too common. We discuss marital disputes mostly in the community during mosque meetings."

Sahib also reports another disturbing phenomenon in his taluk: children of emigrants are becoming delinquents and turning to alcohol and drugs. In Calicut, Santhakumar confirms the rise in juvenile delinquency and says the excess flow of money has ruined a lot of children.

In Kunnamkullam, a 12-year-old boy beat up his mother and demanded money from her. When she refused, he wrote to his father in Abu Dhabi accusing her of having affairs with other men. The marriage almost broke up but the husband came to Kerala and the boy was exposed after a psychiatrist confirmed his pyschopathic personality.

Said Santhakumar: "In fact, the problems of Gulf families seem only to be multiplying with prosperity and seldom do they have a happy married life." Psychiatrists agree on the fact that the alarming rise in mental disorders seem to be directly related to the state's new found prosperity.

They are not the only ones worried about the impact of the inflow of Gulf money. Even economists are alarmed by the extravagant and wasteful expenditures indulged in by the Gulfites. A recent study made by Madras University's Agricultural Economics Research Centre (aerc) has come up with some startling facts about the impact of foreign remittances on the rural economy of Kerala.

Said Dr C. Arputharaj, director of AERC, who headed the study group: "There has been a substantial growth of the nouvean riche. This new class cuts across caste and communal lines and manifests the typical rashness of its new financial power."

Two Muslim women in their house: Absent husbands, cars and desolation

The study found that "mini-Gulfs" have sprouted in the talukas of Chavakkad. Tanur in Mallapuram. Chirayinkil and Varkala in Trivandrum. In each of these, more than 5,000 residents had gone to the Gulf with the largest number of 6,972 coming from Chavakkad. The group, therefore, chose Chavakkad taluk for a sample study of 150 households with at least one member in the Gulf. Some of the facts revealed are:

* The average annual income for each household has increased six-fold after the boom from Rs 3,522 to Rs 21,035 while that of a family which had no members abroad remained static at Rs 5,675;

* The average expenses on food, clothing, education, medicine, recreation and ceremonies shot up from Rs 4,372 to Rs 10,980 while that of normal households stood at a meagre Rs 5,038;

* The total value of assets per household was a phenomenal Rs 3.82 lakh as compared to the all-India average of Rs 11,675. The maximum amount had been invested in buildings and land. The number of terraced houses rose from nine to 74 while thatched ones fell from 59 to II.

* While initially only one house had mosaic flooring, today 61 houses have them. Previously 78 houses were not electrified, now only eight remain. Fourteen houses were valued above Rs 1 lakh; and

Conspicuous by their absence, despite the huge inflow of money, was higher savings and investments. Instead, the families have mostly gone in for "sterile" investments such as land, buildings and consumer durables.

Said Arputharaj regretfully: "Not only have these remittances from Gulf countries remained aloof of the general economy, it has fostered enclaves of high liquidity, making for major shifts in the spending pattern of households which in the long run will add to economic and social instability."

Extravagance: Already Chavakkad is feeling the impact of this unbridled extravagance. Land prices have skyrocketed with a series of "Dubai manzils" sprouting up. Chavakkad now looks like an upper-middle class area in a big city and not the sleepy fishing village that it once was.

Vegetable and meat prices have soared to dizzy levels. A kilo offish which used to cost Rs 5 now costs Rs 25. Labour charges for construction have shot up dramatically and a mason now earns a minimum of Rs 35 as compared to Rs 12 before.

Socially too there has been a drastic change. Cotton clothes have been discarded for synthetics. It has become a status symbol to shop in a car or drive all the way to Trichur town 25 km away to watch a film.

The wealth has led to jealousy and envy among neighbours and an acute consciousness of status. The study group observed "the respect that one commands from others in the neighbourhood depends on money and nothing else".

Psychiatrists believe that the drastic change in the post-boom socio-economic structure has been one of the main causes for the increase in mental disorders. The affluence has split up a lot of homes. A 26-year-old housewife in Trichur became a manic-depressive after her husband decided to lake another wife because he found that he could "afford one more". Her husband refuses to divorce her because he wants her to look after the children.

The doctors are finding it difficult to treat these patients for several reasons. Mohammed said that conventional psychotherapy methods failed as most of the patients felt that their ailments were physical and not mental.

In fact, he had a lot of dropouts when he refused to use a stethoscope, the symbol of a doctor in rural areas. Now he examines their chest perfunctorily with the scope to reassure them. Psychiatrists are now becoming increasingly disheartened as there seems to be no end to the long line of people suffering from the Gulf syndrome.

Said Santhakumar: "Mental illnesses in these families have become more of a rule than an exception. I don't know how we can get out of this muddle." Mohammed sees it as part and parcel of the social change and does not think anything can rectify the damage.

Francis feels that if the in-laws could adjust to their daughters-in-law and treat them more gently, many of the problems could be solved. But he predicts gloomily: "If this wave of victims continues unabated it will destroy the family set-up. Ultimately this may be the factor that will prevent further emigrations."

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